Actuary, Analytics/Forecasting

About the role

Reporting to the Part D CFO, this position will develop and maintain Part D pharmacy forecasting models that support Medicare Advantage and Prescription Drug Plan (PDP) lines of business through financial planning, risk assessment, and comprehensive trend analytics. This newly created role addresses the growing financial complexity and risk associated with the evolving Part D benefit, including significant program changes stemming from the Inflation Reduction Act (IRA). The individual in this position will play a key role in shaping Part D financial strategy, providing actionable insights to senior leadership, and enhancing organizational understanding of the Part D program. This role offers a unique opportunity to deepen expertise in Medicare Part D while expanding Part D financial literacy across the broader organization.

The Actuary, Analytics/Forecasting maintains data integrity by developing and implementing processes and controls for data flow. This role partners with stakeholders to understand business needs, troubleshoot issues, perform root cause analysis, and resolve data anomalies cost-effectively. The position advises executives on significant functional strategies, often specific to a segment, and exercises independent judgment on complex responsibilities and related tasks. Working with minimal supervision, the role analyzes variable factors to determine the most effective course of action.

Responsibilities

• Develop and maintain Part D pharmacy forecasting models for Medicare Advantage and Prescription Drug Plan (PDP) lines of business.
• Support financial planning, risk assessment, and comprehensive trend analytics.
• Maintain data integrity by developing and implementing processes and controls for data flow.
• Partner with stakeholders to understand business needs, troubleshoot issues, and perform root cause analysis.
• Resolve data anomalies in a cost-effective manner.
• Advise executives on significant functional strategies specific to segments.
• Exercise independent judgment on complex responsibilities and tasks.
• Document actuarial analyses and communications in alignment with applicable actuarial standards, including ASOP 41.

Requirements

• Bachelor’s Degree.
• FSA or ASA plus relevant advanced degree, recent and relevant work experience, and/or other relevant professional designations.
• MAAA.
• Demonstrated ability to articulate ideas effectively in both written and oral forms.
• Experience in more than two functions (e.g., modeling, pricing, reporting & analysis, reserving or trending).

Preferred Qualifications

• Actuarial experience in healthcare.
• Experience using SAS, SQL, Snowflake, or other relevant data analytics, database, or reporting tools.
• Experience supporting claims trend analysis, forecasting, business intelligence, or financial analysis in a healthcare or managed care environment.

Benefits

Humana offers competitive benefits that support whole-person well-being, including:

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off (including paid time off, company and personal holidays, paid parental and caregiver leave).
• Short-term and long-term disability.
• Life insurance.

Pay

The pay range for this full-time (40 hours per week) position is $129,300 - $177,800 per year. This job is eligible for a bonus incentive plan based on company and/or individual performance.

Schedule

• Scheduled weekly hours: 40.
• This is a remote position with work-at-home requirements, including:
• Minimum download speed of 25 Mbps and upload speed of 10 Mbps; wireless, wired cable, or DSL connection suggested.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI/HIPAA information.
• Occasional travel to Humana's offices for training or meetings may be required.